Ultrasound or C-arm? A comparative study of surgical intervention for adolescent metaphyseal-diaphysis junction fracture of the distal radius using external fixator

Abstract

Metaphyseal-diaphysis junction (MDJ) is defined as the distal third of the radius subtracted from the square over the radial physis. Because of its unique anatomy, unstable fracture in MDJ poses challenges for a successful conservative method. Multiple modes of surgeries have been reported for MDJ fracture of the distal radius in children after failed manual reduction and casting. This study is to investigate the clinical effects of closed reduction and external fixation for MDJ fractures in children using fluoroscopy versus ultrasound. Ninety-six patients were divided into the ultrasound (US) group and the C-arm (CA) group. According to our results, the surgical duration was significantly shorter in the US group (24.40 ± 6.12, min) compared with the CA group (32.11 ± 9.23, min), P < 0.001. Images taken during the surgery were significantly less in the US group (2.66 ± 1.19) than the CA group (9.52 ± 3.15), P < 0.001. As for the complications, residual angulation, and clinical function of forearms, there was no significant difference between the two groups.